[Is radioiodine therapy conducted too late in patients suffering from thyroid autonomy?]

Nuklearmedizin. 2008;47(1):8-12; quiz N5. doi: 10.3413/nukmed-0073.
[Article in German]

Abstract

Aim: The effectiveness of radioiodine therapy (RIT) is proven. The aim of this study was to determine, how much time passes between diagnosis of thyroid autonomy or occurrence of functional and/or local symptoms on one hand and RIT on the other hand.

Patients, methods: This retrospective study comprises 196 patients, who were treated with radioiodine for thyroid autonomy between 2002 and 2005. Evaluated parameters are begin of functional and/or local symptoms, first scintigraphy with relevant Tc-Uptake as time point of primary diagnosis of thyroid autonomy and time point of implementation of RIT.

Results: Between first scintigraphy with relevant Tc-Uptake and implementation of RIT 0-72 months passed (median: 3 months). 160 patients (81.6%) had a prior diagnosis of goitre by their general practitioner and 163 patients (83.3%) had a prior diagnosis of TSH suppression. The time period between first recommendation of RIT and implementation of RIT was 0-89 months (median: 2 months). In 142 patients (71.4%) functional and/or local symptoms were present over 73 months (median; range: 0-180 months) before the first scintigraphy with therapy relevant Tc-Uptake was conducted.

Conclusion: Despite clear recommendations in corresponding guidelines too much time passes between first symptoms (median: 73 months), primary diagnosis of therapy relevant thyroid autonomy (median: 2 months) and implementation of RIT. Patients with functional and/or local symptoms should be examined for thyroid autonomy early. If thyroid autonomy is proven, RIT should be planned immediately, especially in high-risk patients.

MeSH terms

  • Humans
  • Iodine Radioisotopes / therapeutic use*
  • Radiography
  • Radioisotopes / therapeutic use
  • Radionuclide Imaging
  • Thyroid Diseases / diagnostic imaging*
  • Thyroid Gland / diagnostic imaging

Substances

  • Iodine Radioisotopes
  • Radioisotopes